Mental and Social Health Commons^™

Increasing Patient Awareness And Education Surrounding Prescription Weight Loss Medications, Anirudh A. Hirve

Family Medicine Clerkship Student Projects

Obesity is a growing problem in the United States. While it remains important for clinicians to emphasize health supportive behaviors including dietary modification and exercise when counseling patients, the advent of new weight loss medications has created a need for patient education materials regarding these interventions for a growing number of patients who request them at primary care visits. This project created a smart phrase in the electronic medical record summarizing weight loss medications currently available on the market to transform patient counseling and enable better shared decision making between patients and providers.

Aging Expectations Predict Subjective Cognitive Decline Among Community-Dwelling Older Adults, Justin Do, Bs, Casey Fishman, Ba, Sakshi Bhargava, Phd, Emily Bratlee-Whitaker, Phd, Rn, Jennifer R. Turner, Phd, Jacqueline Mogle, Phd, Ms, Nikki L. Hill, Phd, Rn

Alpha Omega Alpha Research Symposium Posters

Purpose: Subjective cognitive decline (SCD), or perceived decline in cognition, is a precursor to mild cognitive impairment, a prodrome of Alzheimer’s disease. SCD’s predictive utility is limited as it is impacted by multiple psychosocial factors. Expectations regarding aging among older adults have been linked to self-efficacy and health-related outcomes; however, their relationship with SCD is unknown. The aim of this cross-sectional study was to investigate the relationships between older adults’ aging expectations regarding physical, mental, and cognitive health, and SCD.

Methods: An online survey of community-dwelling adults aged 65 years or older (n=582, M(SD)=71.36(4.80)) with no history of dementia …

Developmental Effects Of Child Abuse: The Relevance Of Timing, Laura Luz Alvarez Pineda, Karla Susana Saldaña

Nursing | Student Research Posters

Background: Early physical, sexual, and emotional child abuse has been associated with long-life cognitive, emotional, and physical health repercussions. Purpose: The current paper, in addition to a literature review, proposes a research design to examine the emotional outcomes of physical, emotional, and sexual child abuse on Hispanics when a psychosocial therapy program is implemented. Methods: Participants will be recruited from children’s hospitals, daycares, and preschools around the Bay Area. Parental-informed consent will be obtained prior to participation. This longitudinal quantitative quasi-experimental study will be comprised of three phases to measure posttraumatic stress and depression symptoms, and suicidal …

The Role Of Occupational Therapy And The Use Of Physical Agent Modalities And Occupational Therapy Interventions To Decrease Pain Associated With Endometriosis To Provide Increased Occupational Performance In Leisure Activities, Ciara Autumn Pearce, Keisa Boykin

Fall 2023 Virtual OTD Capstone Symposium

Endometriosis is a condition that can affect women of reproductive age (Kalaitzopoulos et al., 2021). This condition causes endometrial-type tissue to grow outside of the uterus (Kalaitzopoulos et al., 2021). Women diagnosed with endometriosis often have difficulty participating in their daily responsibilities and leisure activities. In a study completed by Lozano-Lozano et al., 2021, 22.6% of women reported limitations in at least one activity of daily living and instrumental activity of daily living. Other limitations include incontinence, meal preparation, leisure activities, and household chores (Mundo-López et al., 2020). Symptoms of endometriosis often include chronic fatigue, anxiety, depression, sexual dissatisfaction, and …

Do Group Medical Visits With A Focus On Mind And Body Help Patients With Chronic Pain And Symptoms Of Depression?, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Health centers can use the results when considering how to help patients with chronic pain and depression reduce their use of pain medicines.

Comparing Two Telehealth Approaches For Treating Psychiatric Disorders In Primary Care, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Federally Qualified Health Centers (FQHCs) are community clinics that provide primary care in rural and other underserved areas. FQHCs often don’t have enough mental health specialists to treat patients with complex mental health conditions.

Comparing Ways To Ask Patients About Sexual Orientation And Gender Identity In The Emergency Department (Ed), Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Sexual and gender minority patients report higher satisfaction and comfort with ED encounters when SO/GI is collected along with other demographic information via a nonverbal, written method during patient registration.

Testing A Standard Approach To Match Patients With Addiction On To Treatment Based On Their Needs, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

The study suggests that use of the ASAM standard of care approach to match patients to treatment may result in improved retention in residential treatment and better patient information and shared decision-making about level of-care decisions.

照顧者實用資訊手冊, 嶺南大學亞太老年學研究中心 Asia-Pacific Institute Of Ageing Studies, Lingnan University, Meng Soi, Florence Fong, Chak Kwan, Dickson Chan, Kin Chung Cheung, Lai Ieng Jay Lau, Sin Yui Sharon Chan, Kin Ho William Li, Ka Ho, Alan Li

Manual & Guide 手冊及指引

手冊源起

香港面對人口高齡化，醫療和福利系統無可避免面臨持續的挑戰。照顧者因壓力問題而引發的家庭悲劇時有發生，反映照顧者自身亦極需要社會的重視和支援。

現時照顧者人數眾多，當中不乏配偶、父母、子女、女婿、媳婦，對長者照顧及社會無酬的付出，確實值得社會的認同和肯定。然而，儘管本港為長者及照顧者提供不少支援服務，由於不同的原因，照顧者似乎未有善用現有的服務，常常需要一力承擔所有照顧的責任，這無疑增加了他們的壓力。

照顧者需求多樣性

照顧者有不同種類，所需要的服務或支援亦有所不同。例如：「新手照顧者」剛開始接觸照顧工作，需要盡快提升日常護理和相關的疾病知識，以及獲得合適的離院/復康服務支援。「隱蔽照顧者」一直承擔照顧工作但沒有接受任何支援，因此，他們需要的是服務提供者/鄰里的主動接觸，並被轉介合適的照顧服務，以分擔他們部分照顧工作。「高危照顧者」幾乎長時間被照顧的工作佔據了其生活，他們需要的是喘息空間和暫託服務，甚至可能是情緒支援。即使「資深的照顧者」也可能需要喘息或暫託的支援服務去減輕壓力；而結束了照顧工作的「畢業照顧者」，無論是情緒的支援，還是重新規劃財務與就業的安排，都有非常實際的需求。基於照顧者的不同需要，照顧者的支援和服務也是多樣化，如何讓不同種類的照顧者能夠輕易了解現有的社區支援服務、可考慮甚麼因素選取相關服務、如何獲取所需的支援包括申領經濟支援或預早準備長期護理開支、如何自強增值等，都是這本手冊希望解答的問題。

手冊的目的

編製這本手冊的目的就是要減少照顧者四處尋找資訊的麻煩，提供一個整全且易於瀏覽的資訊來源。本手冊主要有兩大目標：其一，幫助照顧者認識不同的服務和資源，積極尋求援助；其二是一站式提供豐富的資訊服務，提升照顧者的能力和平衡身心健康。

手冊的意義

此手冊的社會意義是期望提高大眾對照顧者需要的關注，並引導更多的行動以支援照顧者。如果您的親友是照顧者，又或您認識的朋友甚至鄰居正面對照顧家人的困難，您可以主動伸出援手，又或利用這本手冊作為啟示，向他們介紹相關的服務。

另外，這本手冊可以視作為支援照顧者的工具，讓照顧者明白在承擔照顧家人的重任時並不需要孤軍奮戰，也可以善用社區提供的各種資源和服務。

手冊架構

本手冊由四個主要部分組成，每部分都專注於特定的主題，旨在提供照顧者的全方位支援和資訊，幫助他們在面對挑戰時能夠有所依賴，並從中獲得力量：

第一部分主要提供基礎知識，其中包括不同種類的照顧者的介紹、四種長者常見疾病（包括認知障礙、中風、老年抑鬱和癌症）的病徵說明、以及照顧者可能面臨的壓力與「喘息服務」的重要性。第二部分專注介紹長者常用的社區及健康服務。我們按照地區將服務機構進行了分類，羅列「認知障礙、中風、老年抑鬱、癌症」常用的服務機構，此外，我們還提供家居安全、樂齡科技租賃服務，以及財務支援等相關建議。第三部分將焦點重新放回照顧者身上，提供了支援照顧者的社福機構介紹、照顧者同路人的心得分享，以及照顧者的培訓資訊，旨在幫助照顧者在面對困難時能自強不息。最後，在本手冊的結尾部分，我們特別邀請了四位專家學者就照顧者政策提出見解和建議，為加強照顧者支援服務提供新思路。

如果按持份者來分類，手冊的四個部分的重點如下：

第一部分：照顧者的基礎知識

◎ 針對預備照顧者、新手以及隱蔽照顧者，讓他們了解照顧者的角色和需要；照顧體弱長者的基礎知識，並提供應對壓力的建議，包括自我照顧和喘息服務等。

第二部分：照顧者支援

◎ 針對所有護老者，提供長者常用的社區服務、健康服務和支援計劃，包括暫託、住宿、護送及陪診、善別支援、情緒支援、復康用品津貼及租賃的支援計劃，以及財務策劃師提供的理財貼士。

第三部分：照顧者自強

◎ 針對照顧者，資訊包括不同的照顧者支援組織、同路人和畢業照顧者的經驗心得、培訓課程，以及實用的電子資訊平台推介。

第四部分：對照顧者支援政策的看法和展望

◎ 針對服務提供者、政策倡議者及制定者，提供專家學者對照顧者服務及政策的未來發展方向的看法和建議，以期引發更多關於「如何為照顧者提供更好支持」的討論。

給讀者的使用指引

本手冊內容十分豐富，讀者可以先瀏覽目錄，選擇與您相關的部分進行細讀。對於新手照顧者或剛接觸/關注護老服務的人士(例如：學生、社區人士)，我們建議您可以參考手冊第24-33頁「給照顧者的智慧錦囊」的個案，了解不同照顧者可能面對的情境，這可能會給您一點概念，讓您可以考慮尋求哪些支援服務，又或您身邊照顧者朋友有哪些需要，以及如何協助他們獲取所需要的支援。我們深知閱讀本手冊時，您可能會遇到一些不明白的地方，請不必感到困惑。您可以嘗試找身邊的朋友、鄰居或社會服務機構的工作人員一起閱讀，或者向本中心的職員進行查詢。

此外，為方便讀者可以隨時隨地閱讀而不需要攜帶整本手冊，我們為本手冊設立了一個專屬網頁，免費下載整本手冊或某些章節內容。

希望您在閱讀的過程中能找到有用的資訊，並能從中獲得實際的幫助。

Safety And Efficacy Of Adjunctive Esketamine Vs. Maois In Trd In Adults, Riley Guinan

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Background:

Depression affects millions globally - Treatment-resistant depression (TRD) is defined as failure to respond to two antidepressant trials of adequate dose and duration

Traditional Treatment for TRD:

Switching or adding medications atypical antipsychotics - Limitations include delayed action, side effects, and limited efficacy

Alternative Treatment Options:

- Ketamine:

• A dissociative anesthetic with potential antidepressant effects
• Targets the NMDA receptor and activates AMPA receptor.
• Shows rapid and potent antidepressant effects; however, not FDA-approved for depression

- Monoamine Oxidase Inhibitors (MAOIs):

• Antidepressants used since the 1950s
• Inhibits the enzyme metabolizing neurotransmitters.
• Limitations: Dietary restrictions and drug interactions and longstanding safety concerns …

Augmenting Addiction Management: The Potential Efficacy Of Combining Rtms With Cbt, Dylan Schroeder

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Abstract

Non-substance and substance related addictive disorders contribute a high global disease burden with relatively poor treatment options with poor craving control and high relapse rates. CBT is a well-documented treatment modality which is the cornerstone for top-down behavioral management of cravings and preventing relapse, but its clinical efficacy is limited. Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment method which may reduce cravings and relapse rates through a bottom-up neurochemical approach.

There is potential that the rTMS reduction of bottom-up cravings may synergistically enhance the top-down control of cravings established with CBT. Existing primary research demonstrates that a …

Reminiscence Therapy For Prevention Of Post-Stroke Anxiety And Depression In Adults, Carly Porter

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

Anxiety and depression are prevalent after a stroke.^1,2 Peer support is a non-pharmacologic intervention utilized to manage post-stroke anxiety and depression with inconsistent results.³ Reminiscence therapy is an intervention that has been studied in the dementia population but is a relatively new intervention for the stroke population and has the potential to impact the psychological care provided to stroke patients.⁴

The Role Of Repetitive Transcranial Magnetic Stimulation (Rtms) V. Electroconvulsive Therapy (Ect) In Geriatric Depression Treatment: Efficacy & Tolerability, Madeleine Sarro

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Background

• Geriatric depression, or depression in a population over the age of 60, is a highly debilitating mental health condition with a prevalence of 25% versus 10% in the general population.^{1, 2} Increasing prevalence is expected in the next 30 years with a rise in the population size for adults over 60 from 12% to 22%.³
• Limiting variables in the treatment of geriatric depression include polypharmacy, intolerable adverse effects, medical comorbidities, drug resistance and atypical symptom presentation.^2-7
• Due to uniformity in underlying pathophysiology, current treatment guidelines for geriatric depression are the same as for the general population. …

Impact Of Mental Health Boarding In The Emergency Department And Recommendations On How We Can Improve, Kyra Buettner

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

Every year in the United States there is an estimated 2 million adolescents who experience suicidal ideation or attempt suicide.¹ The shortage of behavioral and mental health professionals has led to an increase in emergency department (ED) visits. “Boarding” is defined as “the practice of holding patients in the ED or another temporary location after the decision to admit or transfer has been made.²” The purpose of this study is to evaluate the following question - in adolescent patients with suicide attempt or mental health crisis, does boarding in the ED result in poorer mental health …

Form, Function, And Meaning Of Hiking In Bipoc Communities, Karen Rosales, Karen Park

Summer 2023 Virtual OTD Capstone Symposium

This poster presentation is about understanding the form, function, and meaning for hiking in BIPOC communities. This study used a mixed methods approach to obtain quantitative data through a survey and qualitative data through an interview. Through the use of an Occupational Science approach this study aimed to capture the lived experience of those participating in hiking. Understanding the knowledge of individuals occupations is beneficial for Occupational Therapist when working with versatile populations to understand their motivation and culture.

Community Reintegration Of Formerly Incarcerated Persons: An Occupational Therapy Guidebook, Shauntrice Woodberry, Angela Labrie Blackwell Phd, Otr, Steven Gerardi Phd, Otr

Summer 2023 Virtual OTD Capstone Symposium

The recidivism rates in the US are the highest, as the current research suggests the majority of offenders (two-thirds) released from prison in any given year will be reincarcerated within three years (Eggers et al., 2006). The high rates of recidivism suggest that the criminal justice system has not been able to successfully identify the needs of incarcerated individuals necessary to support the success of their community integration process.

Since there are no published guidelines available to OT practitioners to guide their provision of community reintegration services to formerly incarcerated persons, the product of this capstone was a guidebook.

Exploring The Post-Surgical Needs Of Guatemalan Children And Their Families From Low Socioeconomic Status (Ses) Communities Using An Occupational Therapy Perspective, Diana Del Carmen Tojin Romero, Karen Aranha, Angela Labrie Blackwell

Summer 2023 Virtual OTD Capstone Symposium

Background: Despite a decline in infant mortality rates in the Global South (GS), there has been a rise in congenital and developmental disabilities. International short-term medical (ISTM) missions in Guatemala seek to address the surgical needs of children from low SES communities, but the understanding of the impacts of such assistance and the post-surgical needs of these communities remains limited. Embracing the Human Rights-Based Approach (HRBA) to healthcare as a foundation for this study recognizes health as a fundamental human right. The main tenets of this approach will guide this investigation to understand the post-surgical needs of children and their …

Evidence Based Practices To Guide Practitioners On Providing Racially Informed Care (Ric): A Scoping Review, Veronica Ajose, Angela Labrie Blackwell, Charae Mcconnell

Summer 2023 Virtual OTD Capstone Symposium

All forms of racism impact the health, well-being, safety, and occupations of Black, Indigenous, and People of Color (BIPOC). There is a gap in Occupational Therapy (OT) curricula and literature on how practitioners should address the issue of racism. This presentation presents the background, problem, purpose, methods, results, and implications for occupational therapy practice for a scoping review that sought to review sought to identify and synthesize interventions that align with Racially Informed Care (RIC).

Leisure Exploration For Individuals Recovering From Substance Use Disorder, Laura Head, Susan Macdermott Otd, Otr/L

Summer 2023 Virtual OTD Capstone Symposium

Individuals in recovery from a substance use disorder often report feeling the desire to fill their time with meaning and that time they spent misusing substances was unfulfilling. This poster provides background on what a substance use disorder is and the effects it may have on a person's life. It also dives into the methods used to create, propose, and implement a creative expression group for homeless transitional-aged youth, 18-25, and an exercise group for individuals in recovery from SUD. Finally, this poster discusses the implications of implementing and maintaining programs occupational therapist lead programs in community mental health settings.

Enhance The Use Of Arts, Crafts, And Creative Expression Within Ot Practice, Genevieve England, Susan Macdermott

Summer 2023 Virtual OTD Capstone Symposium

Through the evolution of occupational therapy, the presence of arts and crafts within the profession has decreased. It is a possibility that the cause stems from lack of exposure to crafts, decreased craft related coursework within OT school programming, as well as the shift towards medical model-based OT interventions. The purpose of this project was to gain an understanding of arts and crafts and/or creative expression within OT practice in order to create an effective program.

The Perceived Benefits Of Belonging To A Community Organization For People With Parkinson's Disease (Pwpd): An Ethnographic Study, Alexis Fortes, Mary Ann Smith, Karen Aranha, Kelli Cabrera

Summer 2023 Virtual OTD Capstone Symposium

Background: Persons with Parkinson’s (PwPD) seek to age in place and slow the functional decline that comes with the disease process. Membership in community-based and fitness programs provides a social safe environment that significantly impacts an individual’s psychological well-being and occupational independence. The American Occupational Therapy Association (AOTA) supports and promotes partnering with community organizations that promote and valuemaintaining occupational independence for community dwellers.

Objective: This study investigated the perceived benefits of belonging to a community organization that supports health management and well-being for PwPD.

Methods: A qualitative ethnographic study used immersive participant observation, and conducted two …

Addressing Psychosocial Client Factors In People With Cancer: An Occupational Therapy Guidebook, Hannah Marlette, Steven M. Gerardi, Tiffany Bystra

Summer 2023 Virtual OTD Capstone Symposium

People with cancer have an increased risk of impaired occupational engagement and occupational performance due to the physical, cognitive, and psychosocial impacts of cancer and cancer treatment (Duker & Sleight, 2019; Pergolotti et al., 2016; Polo & Smith, 2018).

The involvement of occupational therapy (OT) in the care of people with cancer remains limited, resulting in a finite amount of literature on OT interventions to address this population (Pergolotti et al., 2016). The primary focus of OT for people with cancer has been on physical client factors and interventions, and people with cancer report that their psychosocial factors are being …

An Occupation Based Program: Supporting Mothers Through Pregnancy And Postpartum, Precious Barnett, Monica Watford, La'shandra Russell

Summer 2023 Virtual OTD Capstone Symposium

This capstone project aimed to discover the effects of occupational therapy services with women who may experience or who are at risk for postpartum depression. Supporting Mothers Through Pregnancy and Postpartum is the developed capstone program. This program included occupation-based activities and resources to encourage occupational participation and engagement. This program used an integrative approach to support the participants of this project. This poster presentation includes background information regarding this population, the methods used to develop the program, program topic themes and goals, and links to view the program’s deliverables.

Breaking The Chains Of Generational Trauma, Carmen Parra

Sociology Student Work Collection

Negative experiences may be passed down from generation to generation resulting in Generational Trauma, many of us may be living with those consequences without ever noticing it. This analysis takes a look at the roots of generational trauma and how it is developed from one generation and repeatedly passed down without a stop. We explore different methods that can be followed for healing and further therapeutic methods for more severe cases.

Occupation Based Program Enhancement: Promoting Social And Leisure Participation Post-Stroke, Emma Welch, Amy Lyons-Brown

Spring 2023 Virtual OTD Capstone Symposium

This presentation describes the importance of social and leisure participation for individuals who have had a stroke and explores the role of occupational therapy in promoting this area of occupation for the population.

Is College Liberating For All Students? The Impact Of Sensory Challenges On Participation Of Students On The Autism Spectrum And With Other Neurodivergent Diagnoses, Sophia Starvaggi, Mary Smith Otr/L, Phd

Spring 2023 Virtual OTD Capstone Symposium

Neurodiversity describes unique ways in which an individual's brain works, impacting skills such as executive function, social interaction, communication, and sensory processing. Sensory processing describes the system which receives, processes, organizes, and responds to sensory information received in several environments throughout the day. Sensory sensitivity involves both over- and under-responsiveness to sensory information received, both causing an impact on one’s participation. An occupational area that seems to lack support for sensory challenges is that of postsecondary, or college, settings.

Several policies exist to protect the right to equal education for students with disabilities, however, these protections only last until students …

Expanding Accessibility For Guests With Autism-Spectrum Disorder (Asd) Who Visit The Jacksonville Zoo And Gardens In Jacksonville, Fl, Lauren Schermerhorn, Thais Petrocelli

Spring 2023 Virtual OTD Capstone Symposium

Problem: Due to public events being commonly characterized by crowded spaces, loud volumes, and unpredictable changes, attractions such as the Jacksonville Zoo can be challenging for those with ASD without proper accommodations (Kimura et al., 2020)

Purpose: The purpose of this capstone project was to advocate for updated evidence-based sensory accommodations at the Jacksonville Zoo and Gardens for those with an ASD diagnosis with the intention of creating a more inclusive zoo experience.

My Path To Advanced Practice, Hannah Oiselle Knisley

Graduate Student Portfolios, Professional Papers, and Capstone Projects

No abstract provided.

Interpretive Phenomenological Analysis [Ipa]: Examining The Impact Of Sleep Disturbances On Lived Experiences Of Persons With Parkinson’S Disease (Pwpd), Adriana Ornelas, Angela Blackwell, Karen Aranha

Spring 2023 Virtual OTD Capstone Symposium

Introduction: This investigation aimed to examine the lived experiences of PwPD who suffer from insomnia. Sleep disturbance affects up to 96% of individuals with PD. The non-motor symptom (NMS) significantly reduces HR-QOL, positively correlates with disease severity and duration, and increases the disease burden of care. Due to the nature of the disease, typical sleep hygiene protocols may not be the most effective intervention for this population. Understanding their challenges is vital to developing a sleep hygiene protocol tailored to their needs.

Methodology: A pilot qualitative study using an interpretive phenomenological analysis (IPA) with PwPD (N=12). The study received IRB …

Examining The Utility Of The Canadian Occupational Performance Measure (Copm) Vs. Cognitive Mapping And Motivational Interviewing (Cm/Mi) To Provide Person-Centered Care (Pcc) For People With Parkinson’S Disease (Pwpd), Mary Lagasca, Karen Aranha

Spring 2023 Virtual OTD Capstone Symposium

Background: Parkinson’s disease (PD) limits occupational engagement and quality of life. Clinicians need tools to help understand the lived experiences of people with PD to provide more person-centered care (PCC). The Canadian Occupational Performance Model (COPM) is one tool used with this population, but its predetermined categories may be limiting. In contrast, Cognitive Mapping and Motivational Interviewing (CM/MI) is a non-standardized method that may provide more insight. Objective: To identify the benefits of the COPM to CM/MI in delivering more person-centered care (PCC). Methodology: A qualitative phenomenological self-study was used. Data collection compared the assessments and reflected on determining if …